Of nursing, vaccines and nurses’ cap
Nursing is the largest educational group in the health sector, accounting for approximately 59 percent of the health professions. According to the state of the world’s Nursing report in 2020, the global nursing work force is 27.9 million, of which 19.3 million are professional nurses. over 80 percent of the world’s nurses are found in countries that account for half of the world population. The global strategy on Human resource for Health in 2016 and the SWNR of 2020 are consistent in estimating the shortage of some 5.6 to 5.7 million nurses in 2030.
It is worthwhile looking at the nursing issues now, before societies run out of nurses who represent a central element of primary health care and health-care systems in countries at all levels of socioeconomic development. Nurses are undisputedly central part of integrated teams in making critical contribution toward universal health coverage and other national and global health outcomes.
the understanding of the essence of the nursing profession and the appreciation of the value of nurses to society are critical factors in giving the nursing profession and the nurses the due regard they deserve that, for the longest time, has been neglected, if not ignored.
this column is dedicated to the nurses, who celebrated 2020 as the Year of Nurses and Midwives as tribute to the 200th birthday of florence Nightingale, and to the society who need to understand what nursing is and what it is not.
Beyond ‘Katulong ng Doctor’
A LEARNING module went viral and stirred reactions when nurses were referred to as katulong ng doctor. While katulong lexically does not refer necessarily to the house helper (which nurses regard as dignified and respectable persons), the reference as “helper” could be improved in the operational contexts of modern professional nursing.
According to the World health Organization, nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people. Key nursing roles include advocacy, promotion of a safe environment, participation in patient and health services management, shaping health policy, education, and research. the title “nurse” should indicate a person who has met the legal, educational and administrative requirements to practice nursing.
the autonomy, which is intrinsic of its professional stature, makes nurses independent and interdependent of and co-equal with the other members of the health team, making katulong ng doctor an outdated concept.
Beyond the nurses’ cap
A TRAILER of a recent filipino movie is going viral for portraying a scene of ladies in undergarments wearing nurses’ cap and using some words that to some sectors may be inappropriate. this is not the first time that nurses cry foul over the cinematic (or even pornographic) use of what nurses do regard as sacred symbol of the profession.
It should be understood that the nurses’ cap is traced back to the religious roots of the profession during the early Christian era worn by deaconesses (or nuns) and thereafter popularized by florence Nightingale. there is even a much-awaited Capping Ceremonies in nursing education to usher the nursing students’ entry into the clinical learning areas of nursing. this professional identification was, however, ditched in the UK and other countries in the early 1990s for evidences that it is harboring bacteria.
It should be noted that the nursing practice is governed by a Code of ethics, an extension of the professional regulatory law, which prescribes standards of professional behavior. the nursing competency standards are keen at harmonizing the acceptable affective behaviors or values with the cognitive intelligence and psychomotor skills or mastery. All of these are taught in nursing schools and tested critically in the Nurses Board examinations.
there are proofs of the nurses’ intrinsic value for ethics. the Gallup Poll in the US finds nursing as the most honest and ethical profession in 2021. this finding is in an impressive undisputed 19 years in a row. the respondents from 50 States rated nurses with an 89 percent “very high/high” score for honesty and ethics among 15 different professions. the doctors ranked next at 77 percent, then the Grade-school teachers at 75 percent.
In the Philippines, a survey conducted by this writer in 2020 rated the caring of nurses at (+)74 percent, higher than any other personnel or amenities in the patients’ hospitalization experience. And there are overwhelming evidences of nurses’ indispensable role in satisfactory patients experience and positive health outcomes.
Beyond commodified barter in exchange of vaccines?
The Philippine Nursing has roadmap 2030, which is described as a balanced-scorecard program of Good Governance of the Nursing Profession. It has a bold vision of becoming and being “the Best for the filipinos and the Choice of the World.”
recently, a news stirred the nurses about the Department of Labor and employment secretary allegedly transacting with United Kingdom and other european countries (that are wanting filipino nurses) in exchange of vaccines. this was clarified and resolved as the secretary’s motive to ensure that the filipino nurses who shall be deployed overseas be vaccinated out of the vaccine supplied of their host countries.
Currently, there is a cap to the global deployment of health workers to only 5,000 per year to preserve the availability of human resource for the country. But there is yet a lack of data and information about the actual health human resource supply of nurses in the country.
the Global Strategy on human resource of health in 2016 noted that the American and european regions face a threat in light of their aging nursing work force. Several high-income countries in the American, european and eastern Mediterranean regions appear excessively reliant on international nursing mobility. these more developed countries are indeed wanting of the filipino nurses. Ironically, the largest shortfall of nurses in absolute numbers remains in the South-east Asia region.
In the Philippines, the Private hospital Association of the Philippines Inc. acknowledges that there is a scarce supply of nurses, forcing some of hospital floors to close for lack of required nursing personnel. the private hospitals, which are also in economic crisis, can hardly match the higher salary of nurses in the public sector. the disparity is caused by the mandate of the Philippine Nursing Law (ra 9173) to provide government nurses the Salary Grade 15 amounting to some above P30,000 plus other benefits provided by the Magna Carta of Public health Workers (ra 7305). the nurses salary prescribed by the 2002 nursing law was, however, implemented in many government hospital only recently—after almost two decades of nurses’ assertive battle.
the positive practice environment is a major issue in the nursing practice. Many well-trained and experienced filipino nurses, both in the clinical setting and the academe, are being given irresistible offers of salaries, benefits, and even citizenships in countries where nurses are given better economic gains and greater career opportunities.
the State of World’s Nursing is clear in its message on the need to invest in nursing education, jobs and leadership. the Philippines, being a primary producer of quality nurses, needs to heed this recommendation before it is too late.
the filipino nurses are making global footprints for being “the choice of the world.” But as to that part of the vision 2030 to be “the best for the filipinos,” the Philippine government should first do something concretely to give nurses the reasons to stay—by giving them a meaningful life at home in a society that makes them feel valued for who they are and for what they do.
The title “nurse” should indicate a person who has met the legal, educational and administrative requirements to practice nursing. The autonomy, which is intrinsic of its professional stature, makes nurses independent and interdependent of and co-equal with the other members of the health team, making katulong ng doctor an outdated concept.